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Coronary Heart Disease

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A pharmacological overview of Statin as a treatment for hyperlipidemia
Coronary heart disease (CHD) is the major cause of death in elderly above the age of 65 [1]. CHD risk associated with diabetes, hypertension, smoking, and elevated cholesterol blood level [2]. Hyperlipidemia is a main cause of atherosclerosis and atherosclerosis-related conditions, like coronary heart disease, peripheral vascular disease, and ischemic cerebrovascular disease. Hyperlipidemia (hypocholesteremia) is correlated with elevated low-density lipoprotein cholesterol (LDL) level and low levels of high-density lipoprotein cholesterol (HDL) [3].
Hyperlipidemia attributes to genetic disorder and sedentary life style (physical inactivity, and diets high in saturated fat …show more content…
Atherosclerotic lesion affects endothelial cells ability to produce nitric oxide and as a result affects vasodilation and constriction mechanisms. Statins therapy exerts cardioprotective effect by improving endothelial function independent on the blood cholesterol level, by inducing transcriptional activation of endothelial nitric oxide synthase (eNOS) [16].
Most of coronary events correlated with unstable atherosclerotic lesion. Statins helps to stabilize atherosclerotic plaque that is associated with coronary events by inhibiting monocyte infiltration through the artery wall and inhibiting metalloproteinases gelatinolytic activity and secretion by macrophages [16].
Therapeutic indication:
Statins are used as a primary prevention to reduce the long-term (more than 10 years) and short-term risk (less than 10 years) associated with CHD. Studies on statins showed a significant reduction in CHD events and death associated CHD. Statins also used as a secondary prevention of CHD to reduce total mortality, major coronary events, and strokes in patients with existing CHD [16].
Statins also used after coronary-artery bypass surgery because patients with coronary-artery bypass surgery are prone to develop local thrombotic occlusion. Statins are used to reduce the progression of the disease and improve graft patency [4].
Adverse effects and drug

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